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AI.L UTIUTTES MUST BE LOCATEU PRK}RT@ANff GRATTHre
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A.rfutfv" gl* *t =g"n fu" * g,rfldLng peo*ft ot"r"t he s*fid bry{frc fttfi€r sf tIrc prsrystY, descrfted aborue, or
mn a*Slnnn'rrzed aggtrt . lrlf tlnre signature bdtouo is rnrda tlmfr. o{ tlne Ousrnrer" a sqalate hettrst d antlnurirty,, sisft€d h,!f tjne
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tesal Access. A Building Permit cannot be issued without proof of legal and adequate access to the property for
plnrposs otr rrmryemiims hy/ dirc edilkftttg DiMiSiffitl.
{Itls ftsrffs. nmuU[ildte sryrate perm{ils nmy he neqpr4lned: ($ Satte EIec{rloail Fefildq P} Ao{tmty (}vt/[s P€rmilL
(3) anrntlnnyr permnrit neqnai,ned fon me on, tlnre pnopertV fidentifired abo,lre" e.g. State on Couftty lrligftuoay/ Rod Access or
a ffie \UUMwffir Dindttwge kttrf,iit.
Void Permit. A Building Permit becomes null and void if the work authorized is not commenced within 180 days of
tftne date off iisslmnre and iiF \lacurlk i'6 suryffided @r ahandomd fur a peillod d ffiCI da6 dter mrumencernnent'.
I CERTIFICATIOTI
it llmrgfoymrtiif\yilffill lhwenearddhibffiliEdiismarddhddhreiinfunmdiiqnffilTffiiir€d&ouei'stnu€andlcunma. ll
underctand that the Bullding Division accepts the Application, aUong wlth the pllans and specifrcatlons and otfier data
srflDfln!fteed hynrne61ron nnnyhdtrldtf (isufurmiMdb)il hmd tupqnr rmnyoertirllircau-um mtoamlrmyr. Asuumrnr-nrgcumtslmonesotr
{lfue ssfundilSdb and Wruordl of diib ,Apslicdiiff}" a euiftfiing ffinftif \siif he iiisrrxdi grdtrtiir psmsiissiiqm to me" f (}w,tfnr, to
construct the structr.rre(S) and facilities detailed on the submittals reviewed by the Building Division. ln consideration of
d,lre1ssuanrneddheeuiMhgturrmiiS, llryrretlhdllandnrmyryorrss!fliflll @rrffSlyuiilhFtcAYiidimrsdarryllirderdl,S@,@r
noca1 thwnegrrdffiituqgdrcw@rka{lddheffib{ld Aoriinmy Slriilkfiinrg0ode, (WfS rquilatiio{ls and ryplfiiaaUle famd use
rregarrrhtions (Aonnn$f fieg[sla0i@d{s$- Clrlil Cmmty dooelopnawrnt fi€qoft'rilrlg a Fefiirxd6 e*sept fsr resMn0tal uset ane scr&liect
ilo Atjidb 7 g1t dhe li61{dl lggg ad Douqd@nrnemt Cs&' ll mlkrnou.thglBP dhet dtrc exik$turg FffrInii[ nna;r he wryoadbd cnr
rwoked, upon notice from the County, if the location, construction or use of the structure{s} and facility(ies), described
&orc, me mm ihrr connsliatre vofiffi aruflw Rqudffiun(s) or anry odhsr q$[indHb lhfru..
tl lhrer6sy grant pennniisslium ter dhe erilffilry Ui,vii$iom ft@ eflmr dtre prupsff" dMtilbed dborc" tb ihrryM dhe vunfflk ll ff'us?dhnr
ar*nowle{ge that the issuance of the Building Permit does not prevent the Buildi4g Official from: {1) requirirqg the
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sfiucture{s} or fa$Wtyges} iif sudr is 'tn viiolatiion of Curnty negulatflm(s} or any o$rer app{icah{e llaw- Rery;jew of Shis
ApdfcatisrU imrdngg$rng stmmfrmdn , and llnryecm-mns otr drc \uffitk bV thre Brui-dkfmg Dwt'won do fiffi @fiuftlfturh dtl a@pfi;xttlse
d nesponrndtrillfrry otr lli#iliig; hf dhe Astrmd\?' d onnurg, onnriiwiionq, @r dim?e$etmihs. & She Ommer;, ll dkmur,tffie dffi
responsibility for compliance with federal, state and local laws and County Regulations rest with me and my authorized
agem[q, 61sfudi'ng wrjtlhxuufi lllnaiiitdilom nnry ardlrt-r@ff desiiglTsr,, eryjhreot atTid/l or hu.ilblor.
I herehy ac}nowledge that I have read and understand th€ Notice and C.ertification aboue aswell as
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OFFICIALTISE ONLV
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